Endocrine Therapy of Breast Cancer

The growth of breast cancer can be significantly altered by the removal or administration of specific hormones. The response of disseminated breast cancer to treatment with hormonal therapy is an index of the biologic nature of the carcinoma and provides a guide to the sequential selection of further therapies. Careful recording of objective measurements of alterations in tumor growth aids in evaluating the nature of tumor responses. Criteria of objective improvement include recalcification of osteolytic lesions; decrease in size by 50% or disappearance of primary tumor masses, skin nodules, or lymph nodes; decrease in size by 50% or disappearance of pulmonary lesions; substantial decrease in size of an enlarged liver with improvement of liver function; and the absence of progression of any lesion. The survival of patients having an objective tumor regression is significantly greater than nonresponders. The initial endocrine therapy is determined by the menopausal age of the patient.